January 31, 2014

Insecure Attachments May Lead To Childhood Obesity

Scientists already know that the quality of the attachment a person shares with their mother affects their relationships with other people, but would you believe it affects your relationship to food and obesity as well? A new study from the University of Illinois and published online in the Journal of Developmental & Behavioral Pediatrics says yes.

"If your mother regularly punished or dismissed your anger, anxiety, or sadness instead of being sensitive to your distress and giving you strategies for handling those feelings, you may be insecurely attached and parenting your children in the same way. A child who doesn't learn to regulate his emotions may in turn develop eating patterns that put him at risk for obesity," said Kelly Bost, a U of I professor of human development and family studies.

The findings document the association between a parent's insecure attachment and the child's consumption of unhealthy foods, which leads to weight gain.

"We wanted to discover the steps that connect attachment and obesity. Scientists know that a person's attachment style is consistently related to the way he responds to negative emotions, and we thought that response might be related to three practices that we know are related to obesity: emotion-related feeding styles, including feeding to comfort or soothe; mealtime routine; and television viewing," she said.

Bost said that children form secure attachments when their caregiver is available and responsive, which gives the child a secure base to explore his or her environment. This attachment also allows the child protection in times of distress or uncertainty, and a source of joy in everyday interactions.

If that secure base isn't available, an insecure attachment forms. According to Bost, children with insecure attachments often experience feelings of anxiety and uncertainty in close relationships. When these children reach adulthood, they are at special risk for ineffective parenting surrounding some of the factors that are implicated in pediatric obesity, she said.

The researchers recruited 497 primary caregivers of 2.5- to 3.5-year-old children. The caregivers completed a widely used questionnaire to determine adult attachment. The questionnaire consisted of 32 questions about the nature of their close relationships, as well as rating themselves on a scale that measured depression and anxiety.

Another questionnaire assessed how parents handled their children's negative emotions; whether they engaged in emotion-related, pressuring feeding styles known to predict obesity; frequency, planning of, and communication during family mealtimes; and estimated hours of television viewing per day.

The families were recruited from the University's STRONG (Synergistic Theory and Research on Obesity and Nutrition Group) Kids program. The program is a cells-to-society approach to the study of childhood obesity, with the children enrolled full-time in 32 daycare centers.

"The study found that insecure parents were significantly more likely to respond to their children's distress by becoming distressed themselves or dismissing their child's emotion. For example, if a child went to a birthday party and was upset because of a friend's comment there, a dismissive parent might tell the child not to be sad, to forget about it. Or the parent might even say: Stop crying and acting like a baby or you're never going over again," she said.

The findings revealed that the pattern of punishing or dismissing a child's sad or angry emotions was significantly linked to comfort feeding, as well as fewer family mealtimes and more TV viewing. These led to children's unhealthy eating, including self-reported sugary drinks, fast foods and salty snacks.

"One explanation might be that insecure moms are more easily overwhelmed with stress, find it more difficult to organize family mealtimes, and allow their children to watch more television as a coping strategy," she suggested.

Valuable insights for health professionals who are working with children and parents can be gleaned from the results, according to Bost.

"Clinicians can help address children's obesity by giving parents practical strategies to help kids deal with negative emotions like anger, sadness, and boredom. That means helping them describe what they're feeling and working on problem-solving strategies with them," she said.

Bost says that typical parenting behaviors, such as telling a child to "clean your plate" or "eat just three more bites and you can have dessert," send the wrong message.

"In fighting childhood obesity, one of the most important lessons we can teach children is to eat when they're hungry and recognize when they're full. We want to encourage children to respond to their internal cues and encourage parents not to promote eating under stress or eating to soothe," she added.

Bost advises that giving busy working parents practical plans for establishing a routine for mealtime planning is useful.